Top

BMC Sports Science, Medicine and Rehabilitation

Published in:

Open Access 01-12-2016 | Research article

Rehabilitation after first-time anterior cruciate ligament injury and reconstruction in female football players: a study of resilience factors

Authors: Urban Johnson, Andreas Ivarsson, Jón Karlsson, Martin Hägglund, Markus Waldén, Mats Börjesson

Published in: BMC Sports Science, Medicine and Rehabilitation | Issue 1/2016

Abstract

Background

Most of the research in the area of psychosocial factors in rehabilitation after sports injuries has focused on risk behaviors, while relatively few studies have focused on behaviors that facilitate rehabilitation. The objective of our study was to understand the psychosocial features that characterize elite female football players who express a resilient behaviour during rehabilitation after a first-time anterior cruciate ligament (ACL) injury and reconstruction.

Methods

A qualitative method was used based on individual in-person interviews and video communication of players who incurred a first-time ACL tear during the 2012 season of the Swedish Women’s Elite Football League. In total, 13 players had a first-time ACL and were interviewed post-season. The interviews were followed by a thematic content analysis. Based on this, eight players were identified as showing resilient behaviors during their rehabilitation and were included in the final analysis.

Results

Three core themes representing psychosocial factors that help players cope successfully with rehabilitation were identified: (I) constructive communication and rich interaction with significant others; (II) strong belief in the importance and efficacy of one’s own actions; and (III) the ability to set reasonable goals.

Conclusions

The findings suggest three core themes of psychosocial factors that characterize first-time ACL-injured elite female football players showing resilience during rehabilitation after ACL reconstruction. Suggestions for medical teams about ways to support communication, self-efficacy, and goal-setting during the rehabilitation process, are provided.

Waldén M, Hägglund M, Werner J, Ekstrand J. The epidemiology of anterior cruciate ligament injury in football (soccer): a review of the literature from gender-related perspective. Knee Surg Sports Traumatol Arthrosc. 2011;19:3–10. doi:10.1007/s00167-010-1172-7.CrossRefPubMed

Waldén M, Hägglund M, Magnusson H, Ekstrand J. Anterior cruciate ligament injury in elite football: a prospective three-cohort study. Knee Surg Sports Traumatol Arthrosc. 2011;19(1):11–9. doi:10.1007/s00167-010-1170-9.CrossRefPubMed

Ardern CL, Taylor NF, Feller JA, Webster KE. A systematic review of the psychological factors associated with returning to sport following injury. Br J Sports Med. 2013;47:1120–6. doi:10.1136/bjsports-2012-091203.CrossRefPubMed

Tripp DA, Stanish W, Ebel-Lam A, Brewer BW, Birchard J. Fear of reinjury, negative affect, and catastrophizing predicting return to sport in recreational athletes with anterior cruciate ligament injuries at 1 year postsurgery. Sports, Exer Perform Psychol. 2011;1:38–48.CrossRef

Ardern CL, Taylor NF, Feller JA, Whithead TS, Webster KE. Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery. Am J Sports Med. 2013;41(7):1549–59. doi:10.1177/0363546513489284.CrossRefPubMed

Brewer BW. Psychology of sport injury rehabilitation. In: Tenenbaum G, Eklund RC, editors. Handbook of Sport Psychology. 3rd ed. New York: John Wiley & Sons; 2007. p. 404–24. doi:10.1002/9781118270011.ch18.

Evans L, Hardy L. Injury rehabilitation: A goal-setting intervention study. Res Q Exerc Sport. 2002;73(3):310–9. doi:10.1080/02701367.2002.10609025.CrossRefPubMed

Brewer BW, Cornelius AE, Van Raalte JL, et al. Protection motivation theory and adherence to sport injury rehabilitation revisited. Sport Psychol. 2003;17(1):95–103.CrossRef

Kolt GS, McEvoy JS. Adherence to rehabilitation in patients with low back pain. Man Ther. 2003;8(2):110–6. doi:10.1016/S1356-689X(02)00156-X.CrossRefPubMed

10.

Malinauskas R. The associations among social support, stress, and life satisfaction as perceived by injured college athletes. Soc Beh Person Int J. 2010;38(6):741–52. doi:10.2224/sbp.2010.38.6.741.CrossRef

11.

Johnson U. Short-term psychological intervention: A study of long-term injured competitive athletes. J Sport Rehab. 2000;9:207–18.CrossRef

12.

Cutuli JJ, Masten AS. Resilience. In: Lopez SJ, editor. Encyclopedia of Positive Psychology. London: Blackwell; 2009. p. 837–43.

13.

White B, Driver S, Warren AM. Considering resilience in the rehabilitation of people with traumatic disabilities. Rehabil Psychol. 2008;53(1):9–17. http://dx.doi.org/10.1037/0090-5550.53.1.9.CrossRef

14.

Berry JW, Elliott TR, Rivera P. Resilient, Undercontrolled, and Overcontrolled Personality Prototypes Among Persons With Spinal Cord Injury. J Pers Assess. 2007;89(3):292–302. doi:10.1080/00223890701629813.CrossRefPubMedPubMedCentral

15.

Wadey R, Evans L, Hanton S, Neil R. An examination of hardiness throughout the sport injury process. Brit J Health Psych. 2012;17(1):103–28. doi:10.1111/j.2044-8287.2011.02025.x.CrossRef

16.

Ievleva L, Orlick T. Mental links to enhanced healing: An exploratory study. Sport Psychol. 1991;5:25–40.CrossRef

17.

Carson F, Polman RCJ. ACL injury rehabilitation: A psychological case study of a professional rugby union player. J Clin Sport Psychol. 2008;2(1):71–91.CrossRef

18.

Wierike SCM, van der Sluis A, van den Akker-Scheek I, Leferink-Gemser MT, Visscher C. Psychosocial factors influencing the recovery of athletes with anterior cruciate ligament injury: a systematic review. Scand J Med Sci Sport. 2013;23(5):527–40. doi:10.1111/sms.12010.

19.

Hägglund M, Waldén M, Ekstrand J. Injuries among male and female elite football players. Scand J Med Sci Sports. 2009;19(6):819–27. doi:10.1111/j.1600-0838.2008.00861.x.CrossRefPubMed

20.

Onwuegbuzie AJ, Leech NL. Sampling designs in qualitative research: Making the sampling process more public. Qual Report. 2007;12(2):238–54.

21.

Crossley ML. Narrative psychology, trauma and the study of self/identity. Theor Psychol. 2000;10(4):527–46. doi:10.1177/0959354300104005.CrossRef

22.

Charmaz K. Grounded theory: Objectivist and constructivist methods. In: Denzin NK, Lincoln YS, editors. Handbook of Qualitative Research. 2nd ed. Thousand Oaks: Sage; 2000. p. 509–35.

23.

Baxter LA. Content analysis. In: Montgomery BM, Duck S, editors. Studying Interpersonal Interactions. London: The Guilford Press; 1991. p. 239–54.

24.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. doi:10.1191/1478088706qp063oa.CrossRef

25.

Graneheim U, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nur Educ Today. 2004;24(2):105–12. doi:10.1016/j.nedt.2003.10.001.CrossRef

26.

Scheier MF, Carver CS. Dispositional optimism and physical well-being: the influence of generalized outcome expectancies on health. J Pers. 1987;55(2):169–210. doi:10.1111/j.1467-6494.1987.tb00434.x.CrossRefPubMed

27.

Ramanathan MS, Wardecjer BM, Slocomb JE, Hillary FG. Dispositional optimism and outcome following traumatic brain injury. Brain Inj. 2011;25(4):328–37. doi:10.3109/02699052.2011.554336.CrossRefPubMed

28.

Wiese-Bjornstal DM. Psychology and socioculture affect injury risk, response, and recovery in high-intensity athletes: a consensus statement. Scand J Med Sci Sports. 2010;20 Suppl 2:103–11. doi:10.1111/j.1600-0838.2010.01195.x.

29.

Podlog L, Eklund RC. The psychosocial aspects of a return to sport following serious injury: a review of the literature from a self-determination perspective. Psychol Sport Exerc. 2007;8(4):535–66. doi:10.1016/j.psychsport.2006.07.008.CrossRef

30.

Polit DF, Hungler BP. Nursing research, Principles and Methods, sixth ed. Philadelphia: JB Lippincott Company; 1999.

31.

Sparkes AC, Smith B. In: Holstein J, Gubruim J, editors. Handbook of Constructionist Research. London: The Guilford Press; 2008. p. 295–314.

Title: Rehabilitation after first-time anterior cruciate ligament injury and reconstruction in female football players: a study of resilience factors
Authors: Urban Johnson
Andreas Ivarsson
Jón Karlsson
Martin Hägglund
Markus Waldén
Mats Börjesson
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Sports Science, Medicine and Rehabilitation / Issue 1/2016
Electronic ISSN: 2052-1847
DOI: https://doi.org/10.1186/s13102-016-0046-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Rehabilitation after first-time anterior cruciate ligament injury and reconstruction in female football players: a study of resilience factors

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2016

Ultrasound assessment of fascial connectivity in the lower limb during maximal cervical flexion: technical aspects and practical application of automatic tracking

Concurrent validity of the Gyko inertial sensor system for the assessment of vertical jump height in female sub-elite youth soccer players

BMC Sports Science, Medicine and Rehabilitation reviewer acknowledgement 2015

Criterion validity and reliability of a smartphone delivered sub-maximal fitness test for people with type 2 diabetes

Investigating physical fitness and race performance as determinants for the ACL injury risk in Alpine ski racing

Development of the Brazilian Portuguese version of the Achilles Tendon Total Rupture Score (ATRS BrP): a cross-cultural adaptation with reliability and construct validity evaluation